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Jobs in Kuwait - career in Kuwait - vacancies in Kuwait-Medical Claims Officer - Alghanim Industries-Jobs in Kuwait - career in Kuwait - vacancies in Kuwait
- Claim Notification, registration in system and acknowledgment to customer.
- Claims documentation requisition, review, and follow-up with customer on missing document (if any)
- Process claims as per the guidelines and follow the claim process.
- Forward the claim to the reporting manager for the approval. Once Approved follow with the concern department for the payment.
- Keep the claim files with proper archiving and forward the file whenever requested.
- Sample Auditing of approved claims from the TPA before making payments that to be vigilant and if any claims come across which was approved against the policy terms escalate to the reporting manager.
- Review all pre-approval request received from TPA/Providers as per the protocol of the service and forward to claims manager.
- To adhere with External and Internal SLA’s.
- Regular follow-up with the customer and update on the claims till the payment.
- Resolve issues and complaints from both TPA/hospitals and clients to facilitate the services.
- Explain Policy terms and the actual application of exclusions to both the providers and clients.
- Review regularly on outstanding claims.
- Prepare OCR for Medical claims and forward to claims manager for his review and approval.
- Conduct analysis
- Follow up for troubleshooting in system and with IT or underwriting department for policy documentation.
Job Details
| Posted Date: |
2021-08-30 |
| Job Location: |
Kuwait |
| Job Role: |
Medical, Healthcare, and Nursing |
| Company Industry: |
Administration Support Services |
Preferred Candidate
| Career Level: |
Mid Career |
| Nationality: |
United Arab Emirates; Bahrain; Djibouti; Algeria; Egypt; Iraq; Jordan; Comoros; Kuwait; Lebanon; Libya; Morocco; Mauritania; Oman; Palestine; Qatar; Saudi Arabia; Sudan; Somalia; Syria; Tunisia; Yemen |
| Degree: |
Bachelor's degree |
Jobs in Kuwait - career in Kuwait - vacancies in Kuwait-Medical Claims Officer - Alghanim Industries-Jobs in Kuwait - career in Kuwait - vacancies in Kuwait
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